Postoperative Radiotherapy for Pancreatic Cancer with Microscopically-positive Resection Margin

Anticancer Res. 2017 Feb;37(2):755-764. doi: 10.21873/anticanres.11374.

Abstract

Aim: To analyze the outcomes in pancreatic cancer (PC) cases with a microscopically-positive resection margin (R1 resection) treated with postoperative radiotherapy (PORT).

Patients and methods: We retrospectively analyzed the outcomes in 62 patients who received PORT for PC with R1 resection between 2001 and 2012. All patients received three-dimensional conformal radiotherapy. Concurrent chemotherapy was administered to 58 patients.

Results: The median follow-up was 20.1 months. The median survival was 22.0 months and the 3-year overall survival rate was 25%. The 3-year disease-free survival and local recurrence-free survival rates were 12% and 54%, respectively. Local recurrence occurred in 23 patients (44%), distant failure in 45 (87%), and both in 16 (31%). By multivariate analysis, the postoperative cancer antigen 19-9 (CA19-9) level and adjuvant chemotherapy were independent prognostic factors for survival.

Conclusion: PORT is associated with a relatively favorable survival outcome in PC with R1 resection. Chemotherapy and postoperative CA19-9 level were significant prognostic factors for survival.

Keywords: Pancreatic cancer; R1 resection; adjuvant radiotherapy.

MeSH terms

  • Adult
  • Aged
  • CA-19-9 Antigen / analysis
  • Chemotherapy, Adjuvant / methods
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Humans
  • Margins of Excision*
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Recurrence, Local
  • Outcome Assessment, Health Care / methods
  • Outcome Assessment, Health Care / statistics & numerical data
  • Pancreatic Neoplasms / drug therapy
  • Pancreatic Neoplasms / radiotherapy*
  • Pancreatic Neoplasms / surgery*
  • Postoperative Period
  • Pregnancy
  • Prognosis
  • Proportional Hazards Models
  • Radiotherapy, Conformal / methods*
  • Retrospective Studies

Substances

  • CA-19-9 Antigen